Traumatic pericarditis in cattle: clinical, radiographic and ultrasonographic findings

Pericarditis is an inflammation of the pericardium with accumulation of serous or fibrinous inflammatory products. In cattle, it is almost always attributable to a reticular foreign body that has penetrated the reticular wall, diaphragm and pericardial sac. The lead signs of pericarditis are tachycardia, muffled heart sounds, asynchronous abnormal heart sounds, distension of the jugular veins and submandibular, brisket and ventral abdominal oedema. The glutaraldehyde test is an important diagnostic tool because it is positive in >90% of affected cattle. Other common laboratory findings are leukocytosis and hyperfibrinogenaemia (indicating inflammation), and elevation of liver enzyme activity (reflecting hepatic congestion). Radiographs of the thorax and reticulum often show a foreign body cranial to the reticulum. In the majority of cases, massive fibrinopurulent adhesions obscure the cardiophrenic angle, cardiac silhouette and ventral diaphragm.Ultrasonography is the method of choice for diagnosis and characterisation of pericardial effusion. Echogenic deposits and strands of fibrin are seen on the epicardium, and the ventricles are compressed by the effusion. Severe pleural effusion is usually evident. In cattle with distension of the jugular veins and tachycardia, the differential diagnosis includes right-sided cardiac insufficiency attributable to other causes. Distension of the jugular veins without signs of right-sided cardiac insufficiency may occur with obstruction or compression of the cranial vena cava. The prognosis is poor, and pericardiocentesis or pericardiotomy are inadequate methods of treatment. Thus, prompt and humane euthanasia is indicated for cattle with traumatic reticuloperitonitis. Because a definitive diagnosis of traumatic reticuloperitonitis is not always possible based on clinical signs alone, radiography and ultrasonography of the thorax and reticulum are indicated in doubtful cases.     

The sensitivity, specificity and predictive value of total plasma protein in the diagnosis of traumatic reticuloperitonitis.

We analyzed the value of total plasma protein in the diagnosis of traumatic reticuloperitonitis in dairy cattle using the concept of sensitivity, specificity and predictive value of a test. Cows with traumatic reticuloperitonitis surgically confirmed at the New York State College of Veterinary Medicine served as cases, while cows surgically explored for other abdominal diseases that might be confused with traumatic reticuloperitonitis during differential diagnosis were controls. The sensitivity of the total plasma protein in diagnosis of traumatic reticuloperitonitis decreased from 97% to 6.3% as the cutoff value for a positive test rose from 65 g/L to 110 g/L, while specificity increased from 11.3% to 99.1% over the same range of cutoff values. Application of these figures to predictive values positive and negative at various prevalence levels of disease is discussed. For example at the measured prevalence level of 37%, 76% of cattle with plasma protein concentrations in excess of 100 g/L had traumatic reticuloperitonitis.     

Accuracy of radiography of the reticulum for predicting surgical findings in adult dairy cattle with traumatic reticuloperitonitis: 123 cases (1981-1987)

Radiographic and surgical findings were compared in 123 cattle suspected of having traumatic reticuloperitonitis. Radiography of the reticulum proved to be a sensitive test for detection of a foreign body (FB). An abnormal FB position on a radiograph was a good predictor of FB perforation. If an FB was fully attached to a magnet, it was unlikely to be perforating the reticular wall. When abnormal reticulum size, abnormal reticulum location, and gas shadows adjacent to the reticulum were found simultaneously on a radiograph, hepatic or perireticular abscess was likely. Reticular radiography proved to be a useful diagnostic aid in cattle suspected of having traumatic reticuloperitonitis.     

Surgery of the bovine forestomach compartments

Surgery of the forestomach compartments is performed in bovine practices for the diagnosis and treatment of many diseases, including traumatic reticuloperitonitis, perireticular abscess, vagal indigestion, and grain overload. Through a left flank laparotomy, the cranial abdomen is first explored by palpation for adhesions or masses. A rumenotomy allows thorough examination of the lumen of the rumen and reticulum. Surgical correction of disease may require emptying of the rumen, removal of a foreign body, or drainage of an abscess into the reticulum. With some abscesses, single aspiration and lavage of the abscess capsule or drainage of the abscess through the body wall, following a ventral celiotomy, is required. If adhesions associated with disease do not affect the innervation of the forestomach, the prognosis for return to functional status within the herd is good. Adhesions involving the medial wall of the reticulum or pericardial and myocardial disease due to extensions of traumatic reticuloperitonitis have a very poor prognosis, and thus slaughter should be considered in affected cases.     

Thrombosis of the cranial vena cava in a cow with bronchopneumonia and traumatic reticuloperitonitis

This paper reports the clinical findings, surgical and medical management, and necropsy of a 6-year-old cow with thrombosis of the cranial vena cava and thrombo-embolic pneumonia following traumatic reticuloperitonitis. The clinical diagnosis was confirmed by necropsy.     

Ultrasonographic findings in 22 cattle with pericarditis traumatica

The goal of the present study was to describe the ultrasonographic findings in 22 cattle with traumatic pericarditis. A 5.0 MHz linear transducer or a 5.0 MHz convex transducer was used to examine the thorax, reticulum and liver. There was severe pleural effusion in 17 heifers and severe pericardial effusion in 13 animals. Echogenic deposits and strands of fibrin were seen on the epicardium of 7 animals. Eighteen cattle had signs of traumatic reticuloperitonitis, and 11 had ascites. Because of cardiac insufficiency, 14 cattle had a markedly enlarged liver due to congestion and 15 had dilatation of the caudal vena cava. Ultrasonography is a useful diagnostic aid for visualisation and characterisation of thoracic and abdominal lesions in cattle with traumatic pericarditis.     

Radiographic findings in 4 cows with traumatic reticuloperitonitis caused by a nonmagnetic copper wire

The goal of this study was to describe the findings in four cows with non-magnetic reticular foreign bodies composed of copper. The cows were referred to our clinic because of reduced appetite and a marked decrease in milk production. Based on the clinical findings, a tentative diagnosis of traumatic reticuloperitonitis was made in all cows. The reticulum of all cows was then examined ultrasonographically and radiographically. In all cows, radiographs of the reticulum showed wire-shaped foreign bodies, ranging from 3 to 7 cm in length, which appeared to have penetrated the reticular wall. Two cows (No. 3, 4) had a magnet in the reticulum close to the foreign body but there was no direct contact between the two. A magnet was administered to cows No. 1 and 2, and radiography of the reticulum was performed for a second time the following day. The magnets were observed in the reticulum; however, they did not contact the foreign bodies. Because all the magnets were correctly placed in the reticulum yet, despite close proximity, did not contact the foreign bodies, the latter were thought to be non-magnetic. Cow No. 1 was slaughtered. Left flank laparoruminotomy was performed in the remaining three cows. In all cows, copper foreign bodies ranging in length from 3.0 to 7.0 cm, were found in the reticulum. They had penetrated the reticular wall and were not attached to magnets. The radiographic findings described in the present study are strongly indicative of a non-magnetic foreign body. Ruminotomy is the treatment of choice but slaughter may also be considered.     

Predictive values for clinical signs of abomasal ulcer disease in adult dairy cattle

A 12-month prospective study was performed to determine the predictive values for clinical signs of abomasal ulcer disease in a hospital population of 296 adult dairy cows which were believed to have gastrointestinal dysfunction. There were 26 ulcer-positive cows (prevalence 8.8%). The occult blood test was a more reliable indicator of abomasal ulcer disease than were the abdominal pain or anemia tests. Only three ulcer-positive cows were negative for all three tests.

Forty-five cows were positive for at least one of the three clinical tests. The principal diseases present in the 22 cows that had false-positive results were traumatic reticuloperitonitis, abomasal displacement, liver disease, cecal volvulus and pneumonia or pleuritis.     

Ultrasound as a decision-making tool in abdominal surgery in cows.

In many patients, abdominal ultrasonography is an excellent diagnostic and prognostic tool. It aids in deciding whether the animal should undergo surgical or medical treatment or be slaughtered. This is particularly true in cattle with traumatic reticuloperitonitis (in combination with radiography of the reticulum) or with a tentative diagnosis of left or right displacement of the abomasum. Ultrasound also is an excellent aid for identification of ileus of the small and large intestine, liver abscesses, cholestasis, various urinary tract disorders, and the different forms of ascites.     

Abomasal impaction of cattle in Saskatchewan

Seventy-five necropsy reports of cattle diagnosed as abomasal impaction by the Pathology Department of the Western College of Veterinary Medicine were reviewed. Twenty percent of all affected animals had lesions of traumatic reticuloperitonitis and 60% were believed to be primarily dietary in origin resulting from the ingestion of too much fibre. The remaining 20% did not fit into either category. Abomasal tears, ulcers, and necrosis of the walls of the rumen, omasum, or abomasum were recorded in almost half of the cases. Pyloric stenosis was not encountered. The disease occurred mostly in winter in association with straw feed. Sixty percent of impacted beef cattle suffered from the dietary form, but the majority of dairy cattle, which would have been fed better diets, had the traumatic form which may have been precipitated by dry fibrous feeds. There was no indication of a higher incidence in heavily pregnant animals. Thirty-five of the animals necropsied had been presented alive, and the clinical features of the two main types of abomasal impaction were examined. Cattle with impactions associated with traumatic reticuloperitonitis were sick for a longer period than those animals with dietary related impactions, were single incident cases, and had a statistically significant rise in serum protein.     

Comparison of blood serum proteins in water buffaloes with traumatic reticuloperitonitis and sequellae

In this study, 73 cows with different types of traumatic reticuloperitonitis (TRP) and sequellae along with 25 healthy buffalo cows were used to evaluate the total blood serum protein and protein electrophoresis. According to rumenotomy or necropsy findings, the affected buffalo cows were classified into acute local TRP (AL-TRP), chronic local TRP (CL-TRP), reticular abscess (RA), acute diffuse TRP (AD-TRP), purulent pericarditis (PPC) and fibrinous pericarditis (FPC). Polyclonal gammopathy was characteristic for the electrophoretogram of buffalo cows with CL-TRP (55%), RA (61.1%) and PPC (62.5%). Various degrees of hypoalbuminaemia, hyper-alpha-globulinaemia and low A/G ratios were the associated changes in all cases of TRP and sequellae. Hyper-beta-globulinaemia was noticed in cases with CL-TRP, RA and PPC. Hyper-gamma-globulinaemia was evident in cases with AL-TRP, CL-TRP, RA and PPC. Hyperproteinaemia was noticed in buffalo cows with local complications of TRP including AL-TRP, CL-TRP and RA. Hypoproteinaemia associated with severe hypoalbuminaemia (>50% reduction compared to controls) and very low A/G ratios (<0.4) characterized buffalo cows with AD-TRP, PPC or FPC. In conclusion, the concentrations and electrophoretic patterns of serum proteins in buffaloes differ according to the anatomical location of the foreign body and the associated pathological lesions.     

Use of a flexible fiberoptic laparoscope as a diagnostic aid in cattle

This study was performed to examine the use of a flexible fiberoptic colonoscope as a diagnostic aid in cattle. Examinations were carried out on a group of normal animals and the effects of laparoscopy on hematological parameters measured. The use of laparoscopy in the diagnosis of left displacement of the abomasum and traumatic reticuloperitonitis was assessed in two separate groups of patients. The results were compared to clinical diagnosis and exploratory laparotomy. No effect was demonstrated on the results of haematological examination in the normal cows and the procedure was concluded to be safe and innocuous. Right flank laparoscopy was not useful in detecting left displacement of the abomasum in any case in this study was not helpful in making a diagnosis. The difficulties of current methods of diagnosing left displacement of the abomasum are discussed. Laparoscopy was useful in detecting and characterizing the lesions of traumatic reticuloperitonitis and was concluded to be superior to clinical examination as a diagnostic test.     

Tracheal signs and associated vascular anomalies in dogs with persistent right aortic arch

Medical records of 55 dogs with 1 or more vascular rings around the esophagus and trachea were reviewed to determine the nature and frequency of related vascular anomalies and to determine the reliability of tracheal deviation on radiographs for the diagnosis of persistent right aortic arch (PRAA). Fifty-two (95%) of the 55 dogs had PRAA. Of the 52 dogs with PRAA, 44% had coexisting compressive arterial anomalies: 17 had retroesophageal left subclavian artery and 6 had double aortic arch with atretic left arch. Characteristic tracheal deviation was consistently present in dogs with PRAA. Moderate or marked focal leftward curvature of the trachea near the cranial border of the heart in dorsoventral (DV) or ventrodorsal (VD) radiographs was found in 100% of available radiographs of 27 dogs with PRAA. Moderate or marked focal narrowing of the trachea also was noted in 74% of DV or VD radiographs and 29% of lateral radiographs of the dogs. Tracheal position in 30 of 30 dogs with megaesophagus and 62 of 63 control dogs was midline or rightward in VD or DV radiographs. Histology in a neonatal dog with PRAA revealed evidence of tracheal deviation and compression even before birth. Focal leftward deviation of the trachea near the cranial border of the heart in DV or VD radiographs is a reliable sign of PRAA in young dogs that regurgitate after eating solid food, and contrast esophagrams are not necessary to confirm the diagnosis of vascular ring compression.     

Post surgical development of inflammatory adhesions and reticular function in cows suffering from traumatic reticuloperitonitis

Inflammatory adhesions between reticulum and ventral abdomen in patients suffering traumatic reticuloperitonitis (TRP) may induce a massive inhibition of reticular contractions and thereby an impairment of the separation process of particles in the reticulorumen. However, a substantial disturbance of digesta passage (Hoflund-syndrome) is found only in a few TRP-cows. We hypothesized that this is due to a retrieval of reticular motility due to rebuilding and degradation of adhesions within months after the removal of the foreign body as the primary inflammatory stimulus. Accordingly, it was the objective of this study (a) to assess the extent and structure of inflammatory adhesions in cows with TRP over a period of six months following surgery and (b) to persecute reticular function by characterizing the sequence of reticular contractions sonographically and by assessment of particle size distribution in the faeces of patients by means of wet-sieving. Twenty-six cows suffering from TRP were studied on the day of rumenotomy (day 1) and on day 6, day 12 and 6 months post operationem. Additionally, six healthy control cows were investigated once. All cows were on a hay and concentrate diet. On day 1, the reticular floor and the reticular wall were affected by adhesions in varying extent in all cows; the contraction distance and contraction velocity of the reticulum were markedly reduced and the portion of large particles in the faces increased compared to healthy cows. On day 12, the portion of large particles did not vary any more from that of control cows; a tendency towards an increased contraction distance compared to day 1 was found. Sonographically, only marginal differences were detected in respect to extent and consistency of adhesions. Six months after rumenotomy, in 9 of 16 re-investigated cows sonography revealed no adhesions at the reticulum at all, in other cases the extent of adhesions shrunk considerably. Contraction distance and contraction velocity and particle size distribution in the faeces were found to be nearly comparable to that of control cows. It is concluded that inflammatory adhesions disappear in the majority of the TRP-patients, as a consequence reticular function normalizes. A serious disturbance of digesta passage seems to develop exclusively in those patients with the most extensive adhesions and may be also in such cows, where the primary adhesions cause the development of extensive abscesses.     

Multimodality characterization of a noncommunicating congenital duodenal duplication cyst causing pyloric outflow obstruction in a young dog

A 10‐month‐old German Shepherd Dog presented for evaluation of intermittent vomiting. Abdominal radiographs revealed a marked right cranial mass effect. Initial differentials included abscess/cyst or less likely neoplasia from undetermined origin. On abdominal ultrasound the mass appeared cystic and thin walled. Computed tomography revealed a large cystic lesion originating from the pyloroduodenal junction causing pyloric outflow obstruction. A noncommunicating duodenal duplication cyst was found on exploratory laparotomy and further confirmed with histopathology and immunohistochemistry. Enteric duplication cyst should be considered as a differential in young dogs with gastrointestinal signs and a cystic abdominal mass detected with different imaging modalities.     

Arteriography in ponies with Strongylus vulgaris arteritis.

Radiographs of the aorta and abdominal arteries were obtained from a normal anesthetized pony following catheterization of a femoral artery for nonselective, semiselective or selective arteriography. The arteries had smooth borders and regular diameters and the branches of the cranial mesenteric artery could be followed distally on the angiogram through to the smaller branches proximal to the bowel wall. Following arteriography, the pony walked normally and there were minimal alterations of the levels of serum muscle enzymes and blood lactate. The procedures for arteriography were repeated in three days. At that time the femoral artery was patent and satisfactory angiograms were obtained. Similiarly, radiographs were obtained from two ponies artificially infected with Strongylus vulgaris. The cranial msenteric artery and some of its branches, the right renal artery and segments of the aorta had irregular borders and were enlarged. Branches of the cranial mesenteric artery could not be followed distally because the flow of the contrast material was blocked. Following the above procedures, euthanasia of all ponies was expedited and the findings of arteritis, thrombosis and dilatation of arteries at necropsy compared favorably with interpretations from the radiographs. At least in the pony, arteriography can be a valuable research and diagnostic tool for the demonstration of lesions associated with verminous arteritis.     

Multi‐modality diagnostic imaging of a cervical articular process fracture in a Thoroughbred horse including a novel C‐Arm imaging technique

Interpretation of cervical radiographs can be challenging due to the complex anatomy and superimposition of osseous structures on either side of the vertebrae. This report describes the investigation of neck pain in a Thoroughbred gelding following a traumatic fall. Several imaging modalities were used to demonstrate the presence of a fracture of the left cranial articular process of the fourth cervical vertebra (C4), including nuclear scintigraphy, ultrasonography, oblique radiographic projections and a novel cineradiographic technique. Oblique radiographs were superior to standard lateral‐lateral radiographs in both the diagnosis and for monitoring the progression of healing of the articular process fracture in this case.     

Failure of omasal transport attributable to perireticular abscess formation in cattle: 29 cases (1980-1986)

During a 7-year period, failure of omasal transport attributable to a perireticular abscess was diagnosed in 29 cows. Affected cattle were examined because of anorexia, hypogalactia, and bilateral abdominal distention. The cows were all female Holsteins, 15 months to 10 years old. The abscess was identified during exploratory celiotomy and rumenotomy or at necropsy. Traumatic reticuloperitonitis was believed to be the cause. Twenty-seven cattle (93%) were treated surgically. The abscess was drained into the reticulum or omasum in 25 cows (86%). Twenty-four cows (83%) survived to the time of discharge from the hospital, and 20 (69%) survived for at least 1 year and became productive members of the herd. This is a better survival rate than that reported for other causes of vagal indigestion.     

Recording of the reticular motility in cattle with experimental and spontaneous traumatic reticuloperitonitis

Using the method described in a previous publication for recording the reticulum action in normal cows the authors have investigated three cows with experimentally produced reticuloperitonitis as well as a group of cows with spontaneous peritonitis under treatment at the stationary clinic. The experimental animals were provided with permanent rumen fistulas.In the three cows with experimentally produced peritonitis the pointed object worked loose spontaneously during the first 24 hrs. The symptoms were mild after the first perforation and became aggravated after further perforations.An abnormally prolonged reticulum interval was recorded immediately after the perforation and continued to be clearly distinguishable for two to three days. In the cows with spontaneous peritonitis, this change was observed only in the acute stage.Prolongation of the second phase of the reticulum was the most pronounced finding from the recordings of the reticular movements, both in the cows with experimental peritonitis and in those in the spontaneous group. The change was at its height after two to seven days, and then subsided gradually in the experimental animals in which repeated recordings had been made.The pressure elevation in reticulum during the contractions was lower both in the animals with experimental peritonitis and in the spontaneous group than in the healthy animals.The cows with reticuloperitonitis also displayed impaired ability to pass the recording catheter from the atrium ruminis to the reticulum.     

SELECTIVE ABDOMINAL ANGIOGRAPHY AS A DIAGNOSTIC METHOD FOR DIAPHRAGMATIC HERNIA IN THE DOG: AN EXPERIMENTAL STUDY

Difficulty in recognition of some diaphragmatic hernias in dogs have stimulated the authors to develop a diagnostic method consisting of selective angiography of the cranial mesenteric and celiac arteries. The basis for the experimen was that each herniated visceral organ is usually displaced with its vessels. The experiment was carried out on 14 mongrel dogs. Four dogs served as controls. Different kinds of diaphragmatic hernias were surgically created in 10 dogs. Survey abdominal radiographs, gastrointestinal tract contrast studies and selective abdominal angiography were performed 14 days later. In angiograms of dogs with omental diaphragmatic hernias, displacement of branches of the left gastroepiploic artery into the thorax was seen. In angiograms of dogs with hepatic diaphragmatic hernias, branches of the common hepatic artery were seen to enter the thorax. In dogs with herniated small intestine, the jejunal branches of the cranial mesenteric artery were seen entering the thorax. Potential possibilities of selective abdominal angiography for diagnosis of diaphragmatic hernias are discussed.